AsthmaPhase 4AIM4:Next StepNCT06572228
Efficacy of Dupilumab Added to Medium Dose Inhaled Corticosteroid/Long-acting Beta-agonist (ICS/LABA) in Comparison to ICS Dose Escalation to High Dose ICS/LABA in Adolescent and Adult Patients With Uncontrolled Asthma
A Phase 4 study testing dupilumab and ICS/LABA in people with Asthma, run by Regeneron Pharmaceuticals at 77 sites in 6 countries.
Trial summary
This study is researching a drug called dupilumab. The study is focused on patients who have uncontrolled asthma. Asthma is a condition where the airways narrow and swell, making it difficult to breathe. Read more about this study
- Who is it for?
- Ages 12 to 80 years
- Conditions the study is for
- Asthma
- What is being tested?
- dupilumab and ICS/LABA
- Type of treatment
- Injection or infusion
- Could I receive a placebo?
- Yes, some participants may receive a placebo
- How many people
- 120 participants
- Where
- 77 sitesin 6 countries
- Study dates
- 26 Aug 2024to 24 Apr 2027
- Phase
- Phase 4
- Are there results?
- Not yet: the study is under way
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 12 to 80 years
- All sexes
- No healthy volunteers
- Child, Adult, Older adult
Who may be able to join
- Diagnosis of asthma for ≥12 months, based on the Global Initiative for Asthma (GINA) 2023 guidance document
- Existing treatment with medium dose ICS/LABA (>250 to 500 μg/day of fluticasone propionate DPI or equivalent, per GINA 2023 guidance document) for at least 3 months with a stable dose ≥1 month prior to visit 1
- Participants requiring a maximum of 3 controllers for their asthma will be considered eligible for this study
- Pre-bronchodilator FEV1, as defined in the protocol
- Reversibility of at least 12% and 200 mL in FEV1 after the administration of 200 to 400 μg albuterol/salbutamol at screening OR a documented history of ≥20% reduction in the FEV1, as defined in the protocol
- Demonstrated adherence to medium dose ICS/LABA on at least 80% of days during the run-in period
Show all 9Show fewer
- ACQ-5 score ≥1.5 at screening (visit 1)
- History of ≥1 severe exacerbation(s) in the previous year before visit 1, but not in the 30 days immediately preceding visit 1
- Biomarker criteria: Baseline blood eosinophil count ≥300 cells/μL at visit 1 (~90% of population), as defined in the protocol
Who cannot join
- Diagnosis of chronic obstructive pulmonary disease (COPD) or other lung diseases which may impair lung function and interfere with treatment assessments
- Clinical evidence of lung disease(s) other than asthma or imaging (Chest X-ray, computed tomography (CT), magnetic resonance imaging [MRI]) with significant findings within 12 months of visit 1 and up to and including the baseline visit (visit 3)
- A participant who experiences a severe asthma exacerbation at any time from 1 month prior to the screening visit (visit 1) up to and including the baseline visit (visit 3), as defined in the protocol
- Weight is less than 30 kilograms
- Current smoker or cessation of smoking within 6 months prior to visit 1 or previous smoker with a smoking history ≥10 pack-years
- Severe concomitant illness(es) that, in the Investigator's judgment, would adversely affect the participant's participation in the study, as defined in the protocol
- Participants cannot be on systemic corticosteroids at any time from 1 month prior to the screening visit (visit 1) through the duration of the run-in period
- NOTE: Other protocol-defined Inclusion/Exclusion criteria apply
Trial locations and contacts
77 sites in 6 countries.
77 sites in 6 countries
United States51 sites
Michigan Medicine
Ann Arbor, Michigan, 48109
Kern Research, Inc
Bakersfield, California, 93301
Paul A. Shapero, M.D.
Bangor, Maine, 04401
The Asthma and Allergy Center
Bellevue, Nebraska, 68123
Treasure Valley Medical Research
Boise, Idaho, 83706
Massachusetts General Hospital
Boston, Massachusetts, 02114
Cincinnati Childrens Hospital and Medical Center
Cincinnati, Ohio, 45229
St Francis Medical Institute
Clearwater, Florida, 33765
Certified Research Associates
Cortland, New York, 13045
Dharma MD PA d/b/a Southwest Family Medicine Associates
Dallas, Texas, 75235
Premier Pulmonary Critical Care and Sleep Medicine
Denison, Texas, 75020
National Jewish Health
Denver, Colorado, 80206
Henry Ford Hospital
Detroit, Michigan, 48202
Clinical Research Associates of Central PA
DuBois, Pennsylvania, 15801
Western Sky Medical Research
El Paso, Texas, 79912
Inova Fairfax Hospital
Falls Church, Virginia, 22042
New York Medical College
Hawthorne, New York, 10532
Henderson Clinical Trials
Henderson, Nevada, 89052
Baylor College of Medicine - Section of Pulmonary and Critical Care
Houston, Texas, 77030
Texas Children's Hospital
Houston, Texas, 77030
University of Kansas Medical Center
Kansas City, Kansas, 66160
Florida Lung, Asthma and Sleep Specialists (FLASS) - Celebration
Kissimmee, Florida, 34746
Modena Allergy & Asthma, Inc.
La Jolla, California, 92037
Antelope Valley Clinical Trials
Lancaster, California, 93534
Bluegrass Allergy Research
Lexington, Kentucky, 40509
Ark Clinical Research, LLC
Long Beach, California, 90815
Family Allergy and Asthma Research Institute
Louisville, Kentucky, 40217
Metroplex Pulmonary and Sleep Center, PA
McKinney, Texas, 75069
Clinical Research Institute, Inc.
Minneapolis, Minnesota, 55402
Montana Medical Research
Missoula, Montana, 59808
Intermountain Medical Center - Murray (Pulmonary Medicine)
Murray, Utah, 84107
Northwell Health at ENT & Allergy Associates
New York, New York, 10016
Newport Native Md, Inc.
Newport Beach, California, 92663
Sneeze Wheeze and Itch Associates
Normal, Illinois, 61761
Lung Sleep Research Institute
North Richland Hills, Texas, 76180
Allergy Asthma and Clinical Research Center
Oklahoma City, Oklahoma, 73120
Childrens Hospital of Orange County Main Campus
Orange, California, 92868
Allergy & Asthma Specialists, P.S.C.
Owensboro, Kentucky, 42301
University of Pittsburgh Asthma and Environmental Health Lung Institute
Pittsburgh, Pennsylvania, 15213
Asthma and Allergy Center of Chicago
River Forest, Illinois, 60305
Rochester Regional Health - Alexander Park - Allergy, Immunology & Rheumatology
Rochester, New York, 14607
South Texas Allergy & Asthma Medical Professionals (STAAMP) Research
San Antonio, Texas, 78229
Raffi Tachdjian MD, Inc.
Santa Monica, California, 90404
Endeavor Health, Skokie Campus
Skokie, Illinois, 60077
Washington University School of Medicine
St Louis, Missouri, 63119
Bensch Clinical Research
Stockton, California, 95207
Integrated Research of Inland, Inc.
Upland, California, 91786
Allergy & Asthma Care of Waco
Waco, Texas, 76712
Allianz Research Institute
Westminster, California, 92683
Clinical Site Partners, LLC DBA Flourish Research
Winter Park, Florida, 32789
Pulmonology Associates Inc.
Wynnewood, Pennsylvania, 19096
Poland9 sites
Centrum Medycyny Oddechowej Mroz SJ
Bialystok, Podlaskie Voivodeship, 15-044
Allergy Clinic NZOZ Homeo Medicus
Bialystok, Podlaskie Voivodeship, 15-687
Uniwersyteckie Centrum Kliniczne, Budynek Centrum Medycyny Nieinwazyjnej
Gdansk, Pomeranian Voivodeship, 80-214
Centrum Medyczne All-Med
Krakow, Lesser Poland Voivodeship, 30-033
Diamond Clinic sp zoo
Krakow, Malopolska, 31-559
European Trial Group (ETG) Warsaw
Warsaw, Mazovian, 02-677
Michał Bogacki - DOBROSTAN
Wroclaw, Lower Silesian Voivodeship, 53301
Lekarze Specjaliści Małolepszy i Partnerzy
Wroclaw, 54239
ALL-MED Specjalistyczna Opieka Medyczna Medyczny Instytut Badawczy
Wroclaw, PL-53-201
Germany8 sites
Praxis fur Pneumologie am Duako
Augsburg, Bavaria, 86150
Lungenpraxis Hohenzollerndamm RCMS
Berlin, 10717
IKF Pneumologie Frankfurt GmbH & Co KG
Frankfurt am Main, Hesse, 60596
KPPK Studienzentrum
Koblenz, Rhineland-Palatinate, 56068
POIS Sachsen GmbH iG
Leipzig, 04347
Velocity Clinical Research Lubeck GmbH (Formerly KLB Gesundheitsforschung Lübeck GmbH)
Lübeck, Schleswig-Holstein, 23552
IKF Pneumologie GmbH & Co. KG
Mainz, 55128
LMU University Hospital Munich
Munich, Bavaria, 81377
Canada7 sites
Dynamic Drug Advancement Ltd.
Ajax, Ontario, L1S 2J5
Institut Universitare de Cardiologie et de Pneumologie de Quebec (IUCPQ) - Universite Laval
Québec, G1V 4G5
Clinique de Specialisee en Allergie de la Capitale
Québec, G1V 4W2
Evidence Based Medical Educator Inc.
Toronto, Ontario, M5G 1E2
Inspiration Research Limited
Toronto, Ontario, M5T 3A9
The Lung Centre at Vancouver General Hospital
Vancouver, British Columbia, V5Z 1M9
Dr. Syed Anees Medicine Professional Corporation
Windsor, Ontario, N8X 1T3
About this study
Official title: AIM4: Next Step - Asthma Uncontrolled With ICS in Medium Dose (GINA 4): Next Step; Efficacy of Dupilumab Added to Medium Dose ICS/LABA in Comparison to ICS Dose Escalation to High Dose ICS/LABA in Patients With Uncontrolled Asthma
This study is researching a drug called dupilumab. The study is focused on patients who have uncontrolled asthma. Asthma is a condition where the airways narrow and swell, making it difficult to breathe. Uncontrolled asthma means that patients are still having frequent symptoms while taking their current asthma medication.
The aim of the study is to see which regimen is more effective: taking dupilumab with an inhaled asthma medication or only taking a higher dose of the inhaled asthma medication. The type of asthma medication that will be used is a combination inhaled corticosteroid and long-acting beta-agonist (referred to as an ICS/LABA). Some patients may also receive an additional asthma medication called a long-acting muscarinic antagonist (referred to as a LAMA) if they are already receiving a LAMA.
Read more
The study is also looking at:
- What side effects may happen from taking dupilumab
Read the detailed description
This study is a Phase 3b in Canada Minors will not be enrolled in Denmark
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
dupilumabDrug
Also called Dupixent®, REGN668, SAR231893
Administered by subcutaneous (SC) injection
Matching PlaceboDrug
Administered by SC injection
ICS/LABADrug
Also called fluticasone, propionate/salmeterol HFA, inhalation aerosol
Administered at a blinded dose
| Study group | Role | What they receive |
|---|---|---|
| Dupilumab + ICS/LABA | Experimental | Randomized 1:1 Receives: Drug: dupilumab; Drug: ICS/LABA |
| Placebo + ICS/LABA | Placebo comparator | Randomized 1:1 Receives: Drug: Matching Placebo; Drug: ICS/LABA |
What is being measured
The primary outcome is the main question the study is designed to answer.
Annualized severe asthma exacerbation rate
Measured: Baseline through Week 52
Secondary outcomes (14)
Change in pre-bronchodilator Forced expiratory volume in the first second (FEV1)
Measured: Baseline to week 12
Annualized cumulative dose of systemic corticosteroid exposure to treat severe asthma exacerbations
Measured: Baseline to week 52
Change in Asthma Control Questionnaire (ACQ-5)
The ACQ-5 has 5 items that assess the most common asthma symptoms: 1. Frequency in past week awoken by asthma during the night, 2. Severity of asthma symptoms in the morning, 3. Limitation of daily activities due to asthma, 4. Shortness of breath due to asthma and 5. Wheeze. Participants are asked to recall how their asthma has been during the previous week and to respond to the symptom questions on a 7-point scale (0=no impairment, 6=maximum impairment). The ACQ-5 global score is the mean of the 5 questions and, therefore, between 0 (totally controlled) and 6 (severely uncontrolled). Higher score indicates lower asthma control.
Measured: Baseline to week 12
Proportion of participants achieving ACQ-5 <1.5
Measured: At week 12
Change in pre-bronchodilator FEV1
Measured: Baseline up to week 52
Change in percent predicted FEV1
Measured: Baseline up to week 52
Change in peak expiratory flow (PEF)
Measured: Baseline up to week 52
Change in forced vital capacity (FVC)
Measured: Baseline up to week 52
Change in forced expiratory flow (FEF) 25-75%
Measured: Baseline up to week 52
Change in FEV1: FVC ratio
Measured: Baseline up to week 52
Change in post-bronchodilator FEV1
Measured: Baseline up to week 52
Time to first severe exacerbation event
Measured: Up to week 52
Proportion of participants achieving a 0.5-point improvement minimal clinically important difference (MCID) in ACQ-5
Measured: Up to week 52
Incidence of Treatment-emergent adverse event (TEAEs)
Measured: Up to week 52
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted27 Aug 2024
- Study start26 Aug 2024
- Primary completion24 Apr 2027 (estimated)
- Study completion24 Apr 2027 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for AsthmaStudies of the same condition, open and under way.
- More trials run by Regeneron PharmaceuticalsThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase 4
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Quadruple blind
- Who is masked
- Participant, Care provider, Investigator, Outcomes assessor
- Enrolment
- 120 participants (actual)
Sponsor and investigators
- Lead sponsor
- Regeneron Pharmaceuticals
- Sponsor type
- Industry (pharma, biotech, devices)
- Collaborators
- Sanofi
- Responsible party
- Sponsor
- Investigators
- Clinical Trial Management, Study director, Regeneron Pharmaceuticals
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT06572228
- Sponsor's protocol ID
- R668-AS-2373
- Other IDs
- 2023-510458-18-00, 2023
- Acronym
- AIM4:Next Step
- Status last verified
- Apr 2026
- First submitted
- 23 Aug 2024
- Last updated
- 22 May 2026
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- Yes
- FDA-regulated device
- No
- Individual data sharing
- Yes: All Individual Patient Data (IPD) that underlie publicly available results will be considered for sharing.
Study at a glance
From the registry record, last updated by the sponsor on 22 May 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- AIM4: Next Step - Asthma Uncontrolled With ICS in Medium Dose (GINA 4): Next Step; Efficacy of Dupilumab Added to Medium Dose ICS/LABA in Comparison to ICS Dose Escalation to High Dose ICS/LABA in Patients With Uncontrolled Asthma
- ClinicalTrials.gov ID
- NCT06572228
- Acronym / sponsor ID
- AIM4:Next Step / R668-AS-2373
- Conditions
- Asthma
- Keywords
- Uncontrolled, Severe exacerbations, Type 2 Inflammation, Elevated blood eosinophils, Increased Fractional exhaled Nitric Oxide (FeNO), Atopy and elevated Immunoglobulin E (IgE)
- Phase
- Phase 4
- Study type
- Interventional
- Recruitment status
- Active, not recruiting
- Enrolment
- 120 participants (actual)
- Lead sponsor
- Regeneron PharmaceuticalsIndustry (pharma, biotech, devices)
- Collaborators
- Sanofi
- Study start
- 26 Aug 2024 (actual)
- Primary completion
- 24 Apr 2027 (estimated)
- Study completion
- 24 Apr 2027 (estimated)
- First posted
- 27 Aug 2024 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
This study is researching a drug called dupilumab. The study is focused on patients who have uncontrolled asthma. Asthma is a condition where the airways narrow and swell, making it difficult to breathe. Uncontrolled asthma means that patients are still having frequent symptoms while taking their current asthma medication.
The aim of the study is to see which regimen is more effective: taking dupilumab with an inhaled asthma medication or only taking a higher dose of the inhaled asthma medication. The type of asthma medication that will be used is a combination inhaled corticosteroid and long-acting beta-agonist (referred to as an ICS/LABA). Some patients may also receive an additional asthma medication called a long-acting muscarinic antagonist (referred to as a LAMA) if they are already receiving a LAMA.
The study is also looking at:
- What side effects may happen from taking dupilumab
Detailed description
This study is a Phase 3b in Canada Minors will not be enrolled in Denmark
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Quadruple blind (participant, care provider, investigator, outcomes assessor)
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| Dupilumab + ICS/LABA | Experimental | Drug: dupilumab, Drug: ICS/LABARandomized 1:1 |
| Placebo + ICS/LABA | Placebo comparator | Drug: Matching Placebo, Drug: ICS/LABARandomized 1:1 |
Who may qualify
- Ages
- 12 to 80 years
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Child, Adult, Older adult
Key inclusion criteria (9 listed)
- Diagnosis of asthma for ≥12 months, based on the Global Initiative for Asthma (GINA) 2023 guidance document
- Existing treatment with medium dose ICS/LABA (>250 to 500 μg/day of fluticasone propionate DPI or equivalent, per GINA 2023 guidance document) for at least 3 months with a stable dose ≥1 month prior to visit 1
- Participants requiring a maximum of 3 controllers for their asthma will be considered eligible for this study
- Pre-bronchodilator FEV1, as defined in the protocol
- Reversibility of at least 12% and 200 mL in FEV1 after the administration of 200 to 400 μg albuterol/salbutamol at screening OR a documented history of ≥20% reduction in the FEV1, as defined in the protocol
Key exclusion criteria (8 listed)
- Diagnosis of chronic obstructive pulmonary disease (COPD) or other lung diseases which may impair lung function and interfere with treatment assessments
- Clinical evidence of lung disease(s) other than asthma or imaging (Chest X-ray, computed tomography (CT), magnetic resonance imaging [MRI]) with significant findings within 12 months of visit 1 and up to and including the baseline visit (visit 3)
- A participant who experiences a severe asthma exacerbation at any time from 1 month prior to the screening visit (visit 1) up to and including the baseline visit (visit 3), as defined in the protocol
- Weight is less than 30 kilograms
- Current smoker or cessation of smoking within 6 months prior to visit 1 or previous smoker with a smoking history ≥10 pack-years
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| dupilumabAlso: Dupixent®, REGN668, SAR231893Administered by subcutaneous (SC) injection | Drug | Dupilumab + ICS/LABA |
| Matching PlaceboAdministered by SC injection | Drug | Placebo + ICS/LABA |
| ICS/LABAAlso: fluticasone, propionate/salmeterol HFA, inhalation aerosolAdministered at a blinded dose | Drug | Dupilumab + ICS/LABA, Placebo + ICS/LABA |
Primary outcome
Annualized severe asthma exacerbation rate
Time frame: Baseline through Week 52
14 secondary outcomes
Change in pre-bronchodilator Forced expiratory volume in the first second (FEV1)
Time frame: Baseline to week 12
Annualized cumulative dose of systemic corticosteroid exposure to treat severe asthma exacerbations
Time frame: Baseline to week 52
Change in Asthma Control Questionnaire (ACQ-5)
Time frame: Baseline to week 12
Proportion of participants achieving ACQ-5 <1.5
Time frame: At week 12
Change in pre-bronchodilator FEV1
Time frame: Baseline up to week 52
Change in percent predicted FEV1
Time frame: Baseline up to week 52
Change in peak expiratory flow (PEF)
Time frame: Baseline up to week 52
Change in forced vital capacity (FVC)
Time frame: Baseline up to week 52
Change in forced expiratory flow (FEF) 25-75%
Time frame: Baseline up to week 52
Change in FEV1: FVC ratio
Time frame: Baseline up to week 52
Change in post-bronchodilator FEV1
Time frame: Baseline up to week 52
Time to first severe exacerbation event
Time frame: Up to week 52
Proportion of participants achieving a 0.5-point improvement minimal clinically important difference (MCID) in ACQ-5
Time frame: Up to week 52
Incidence of Treatment-emergent adverse event (TEAEs)
Time frame: Up to week 52
Results and safety
This study is still under way. Results are not available in the source record yet.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 22 May 2026.
- Individual participant dataSharing planned: Yes. All Individual Patient Data (IPD) that underlie publicly available results will be considered for sharing.
Related trials for Asthma
RecruitingPhase 1
Pilot Study to Identify the Mediators and Inflammatory Cell Surface Receptors Involved in Allergic Airway Inflammation
Asthma
RecruitingPhase 1
A Study to Compare the Relative Potency of Salbutamol Administered Via Metered Dose Inhalers (MDI) Containing Propellants HFA-152a to HFA-134a in Mild Asthmatics Aged 18 to 65 Inclusive
Asthma, Mild Asthma
RecruitingPhase 3
A Study Assessing the Effect of Dupilumab on Inducing Clinical Remission in Asthma
Asthma Control
Active, not recruitingPhase 2/3
Local Antibiotic Delivery for Community Acquired Pneumonia
Community Acquired Pneumonia (CAP)
RecruitingPhase 2
A Study to Learn About the Study Medicine Called PF-07275315 in People With Moderate-To-Severe Asthma
Asthma
Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Clinical Trial Management study director
Regeneron Pharmaceuticals
77 sites in 6 countries: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A Phase 4 study testing dupilumab and ICS/LABA in people with Asthma, run by Regeneron Pharmaceuticals at 77 sites in 6 countries.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 9 inclusion and 8 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: under way, not looking for participants, as of the sponsor's last update on 22 May 2026. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 77 sites in United States, Poland, Germany, Canada, Denmark and 1 more country. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. Some participants in this study may receive a placebo. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
What does this phase mean?
Phase 4 studies take place after a treatment is approved, to learn more about its long-term benefits and risks in everyday use.
Not every study follows the same path, and some studies (observational studies, device studies) have no phase.
Are results available for this study?
This study is still under way. Results are not available in the source record yet.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Annualized severe asthma exacerbation rate (time frame: Baseline through Week 52). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 22 May 2026.